• Prior Authorization, RN - Hybrid Remote

    Fallon Health (Worcester, MA)
    …the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, ... testing utilizing established state, federal, and internally developed benefit and clinical coverage criteria against FH polices and protocols. Medical necessity… more
    Fallon Health (10/02/25)
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  • Primary Care Triage Nurse

    Commonwealth Care Alliance (Boston, MA)
    …lab orders and follow-up as delegated. + Completes other duties as assigned by Clinical Manager . + Have a commitment to observing, reporting, and enhancing ... is under the general supervision of the Primary Care Manager and Clinical Director. **Supervision Exercised:** +...to internal and external auxiliary resources such as CCA clinical group CHW, Rehab , Nursing and APCs,… more
    Commonwealth Care Alliance (09/25/25)
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  • Engagement Center Associate

    Commonwealth Care Alliance (Springfield, MA)
    …and social needs. This person will report to the Engagement Center Manager . The Associate, Engagement Center will support the innovative programming and operations ... Center will focus on: 1) Supporting the Director and Manager in organizing and managing programming and flow in...Exercised: None Essential Duties & Responsibilities: * Documents all clinical work in a timely manner and provides the… more
    Commonwealth Care Alliance (10/02/25)
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  • Registered Nurse, BHPMW

    South Middlesex Opportunity Council (Worcester, MA)
    …members in the assigned consortium entity (CE) or affiliated partner (AP) agency. + Liaison to and consult with the BHPMW BHCP Medical Director. + Conduct medication ... setting + Demonstrated knowledge base and judgment necessary for independent clinical decision making. + Excellent verbal and written communications skills. Strong… more
    South Middlesex Opportunity Council (10/10/25)
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